British journal of nursing (Mark Allen Publishing)
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This article describes the development, introduction and implementation of'Guidelines for Pain Management in the Opioid-Dependent Patient' in Yeovil District Hospital NHS Foundation Trust, Somerset. It incorporates the relevant background experiences within the organization and establishes the rationale for the development of the guidelines. ⋯ This project challenged old ways of working and embraced new expanding roles. Indications are that both the quality of care and the patient experience have improved as a direct result of the implementation of these guidelines.
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Sepsis kills more people than lung cancer, and more people than bowel and breast cancer put together. The costs to the NHS are significant; it is estimated that in Europe, patients with severe sepsis cost healthcare funders around 7.6 billion euros per year (Daniels et al, 2007). Costs in the United States are estimated at $16 billion annually (Angus et al, 2001), and in the United Kingdom up to 46% of intensive care unit (ICU) bed days are used by patients with severe sepsis (Padkin et al, 2003), with each ICU bed costing around pounds sterling1700 per day. ⋯ A lot of the early work has concentrated on improving sepsis care in intensive care units, but many patients on general wards develop sepsis, and the need to educate nurses throughout all areas of the hospital has been recognized. In September 2007 a new part of the campaign was launched called Survive Sepsis, which aims to deliver sepsis education to ward nurses and junior doctors. This article discusses how to recognize severe sepsis and explains how nurses can dramatically improve a patient's chance of survival by ensuring that six simple things (Sepsis Six) are done in the first hour.
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One of the crucial features of the Mental Capacity Act (MCA) 2005 was recognizing in a statute the ability of a person to refuse treatment at a subsequent time when he or she lacked the mental capacity to decide on treatment. This refusal, known as an advance decision or living will or advance refusal had been recognized at common law, i.e. judge-made law. This article, continuing the series on the MCA explains the statutory provisions, the specific requirements which must be satisfied if life-sustaining treatment is refused in advance and looks at a practical situation to illustrate the statutory provisions. The link between advance decisions are lasting powers of attorney is also discussed.